Obesity promotes chronic inflammation in peripheral tissues such as adipose tissue and liver, which leads to a wide range of metabolic dysfunctions, a phenomenon called ?meta-inflammation?. Macrophages are key immune-modulators of meta-inflammation, comprised of pro-inflammatory M1 and anti-inflammatory M2. Reprograming macrophage polarization is thought to have great potential for treatment of obesity-induced inflammation and metabolic dysfunctions. However, the regulatory mechanisms of macrophage polarization are not well understood. Growth hormone secretagogue receptor (GHS-R), is known to bind to nutrient-sensing obesogenic gut hormone ghrelin. Our studies with GHS-R global deletion mice have shown that GHS-R is an essential metabolic regulator; its signaling activation is indicative of systemic metabolic and inflammatory state. We reported that GHS-R ablation protects against diet-induced obesity and insulin resistance in aging. We also have evidence that GHS-R has cell-autonomous effect in macrophages, and knockdown of GHS-R shifts macrophages toward M2 spectrum. We hypothesize that GHS-R is a key regulator of macrophage polarization; GHS-R reprograms macrophages toward pro-inflammatory state under diet-induced obesity, leading to inflammation and lipid accumulation in adipose tissue and liver. We will unravel the roles and pertinent mechanisms of GHS-R in macrophage polarization using our newly-generated myeloid-specific GHS-R knockout and re-expression mice. The following comprehensive and complementary Specific Aims will be conducted: Aim 1. Determine whether macrophage GHS-R promotes pro-inflammatory polarization of macrophages under diet-induced obesity, increasing inflammation and lipid deposition in adipose tissue and liver (In vivo studies). Aim 2. Examine whether GHS-R controls macrophage polarization via cell-autonomous action, and promotes inflammation in adipocytes and hepatocytes via paracrine action (Ex vivo studies). Aim 3. Investigate molecular mechanisms by which GHS-R regulates macrophage polarization. We anticipate that GHS-R has a crucial role in macrophage polarization and meta-inflammation in adipose tissues and liver. Specifically, we predict that GHS-R, via insulin signaling, reprograms signaling pathways of fatty acid oxidation and glycolysis, in turn regulating the expression of pro-inflammatory cytokines. This proposal will shed light on a new paradigm for regulating macrophage phenotypic switch, and likely uncover a novel regulatory mechanism linking nutrient sensing, inflammation and metabolism. This proposal will also provide ?proof-of-concept? evidence whether targeting GHS-R in macrophages would be an unique and powerful strategy for combating obesity and inflammation.